Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-23T17:38:11.075Z Has data issue: false hasContentIssue false
  • English
  • Français

Visual loss following head and neck surgery

Published online by Cambridge University Press:  18 October 2011

A J B Crockett ,
A Trinidade ,
P Kothari  and
J Barnes
A J B Crockett
Affiliation:
Department of ENT, Luton and Dunstable Hospital, Luton, UK
A Trinidade*
Affiliation:
Department of ENT, Luton and Dunstable Hospital, Luton, UK
P Kothari
Affiliation:
Department of ENT, Luton and Dunstable Hospital, Luton, UK
J Barnes
Affiliation:
Department of Ophthalmology, Luton and Dunstable Hospital, Luton, UK
*
Address for correspondence: Mr Aaron Trinidade, Department of ENT, Luton and Dunstable Hospital, Lewsey Road, Luton LU4 0DZ, UK Fax: +44 (0)1582 718 281 E-mail: aarontrinidade@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

Non-arteritic ischaemic optic neuritis is a known post-operative complication of ophthalmological and maxillofacial surgery, but has not been widely described as a potential consequence of head and neck surgery.

Aim:

To highlight non-arteritic ischaemic optic neuritis as a potential risk in patients undergoing head and neck surgery.

Subject and method:

Case report of a 60-year-old man undergoing total laryngectomy and bilateral neck dissection for laryngeal squamous cell carcinoma.

Result:

On day 14 post-operatively, the patient suffered substantial oral bleeding secondary to an internal jugulo-neopharyngeal fistula. Following emergency haemostatic measures, the patient was immediately aware of visual disturbances. The ophthalmologists concluded that these were due to non-arteritic ischaemic optic neuritis, caused by acute hypoxaemia secondary to substantial blood loss.

Conclusion:

The prognosis of non-arteritic ischaemic optic neuritis is poor. Thus, it is crucial that otolaryngologists are aware of this complication of head and neck surgery, as immediate diagnosis and treatment can help prevent worsening visual loss.

Keywords

Neck DissectionOptic NeuritisBlindnessComplications
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 4 , April 2012 , pp. 418 - 420
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Schobel, GA, Schmidbauer, M, Millesi, W, Undt, G. Posterior ischemic optic neuropathy following bilateral radical neck dissection. Int J Oral Maxillofac Surg 1995;24:283–7Google Scholar
2Aydin, O, Memisoglu, I, Ozturk, M, Altintas, O. Anterior ischemic optic neuropathy after unilateral radical neck dissection: case report and review. Auris Nasus Larynx 2008;35:308–12Google Scholar
3Wilson, JF, Freeman, SB, Breene, DP. Anterior ischemic optic neuropathy causing blindness in the head and neck surgery patient. Arch Otolaryngol Head Neck Surg 1991;117:1304–6Google Scholar
4Nawa, Y, Jaques, JD, Miller, NR, Palermo, RA, Green, WR. Bilateral posterior optic neuropathy after bilateral radical neck dissection and hypotension. Graefes Arch Clin Exp Ophthalmol 1992;230:301–8Google Scholar
5Holy, SE, Tsai, JH, McAllister, RK, Smith, KH. Perioperative ischemic optic neuropathy: a case control analysis of 126,666 surgical procedures at a single institution. Anesthesiology 2009;110:246–53Google Scholar
6Kerr, NM, Chew, SS, Danesh-Meyer, HV. Non-arteritic anterior ischaemic optic neuropathy: a review and update. J Clin Neurosci 2009;16:994–1000Google Scholar
7Torossian, A, Schmidt, J, Schaffartzik, W, Wulf, H. Loss of vision after non-ophthalmic surgery: systematic review of the literature on incidence, pathogenesis, treatment and prevention [in German]. Anaesthesist 2006;55:457–64CrossRefGoogle ScholarPubMed
8Buono, LM, Foroozan, R. Perioperative posterior ischemic optic neuropathy: review of the literature. Surv Ophthalmol 2005;50:15–26Google Scholar
9Obuchowska, I, Mariak, Z. Perioperative posterior ischemic optic neuropathy – pathogenesis and clinical characteristics. Klin Oczna 2009;111:375–7Google Scholar